Lower Abdominal Pain After Menstruation: Should You Be Concerned?

For most women, the arrival of a period signals a few days of discomfort. We stock up on chocolate, dig out the hot water bottle, and mentally prepare for cramps. We accept this as part of the monthly cycle. But what happens when the bleeding stops, but the pain doesn’t?

Experiencing lower abdominal pain after your period has finished can be confusing and alarming. You expect relief once the cycle is done, so lingering aches or sharp twinges can feel like a betrayal by your own body. Is it just a “hangover” from a difficult cycle, or is it a sign of something more serious?

While occasional discomfort can be normal, persistent pain after menstruation is often your body’s way of signalling that something requires attention. It is not something you should simply “push through.”

This article explores the potential reasons behind post-menstrual pelvic pain, helping you distinguish between minor fluctuations and conditions that necessitate medical advice.

Understanding the “Normal” Cycle

To understand why pain might persist, we first need to understand what is typical. “Dysmenorrhea” is the medical term for period pain, usually caused by the uterus contracting to shed its lining. This typically subsides as the bleeding tapers off.

Sometimes, women experience “Mittelschmerz,” or ovulation pain. This occurs mid-cycle, usually about two weeks after your period starts. If your pain hits exactly mid-month, it might simply be your ovary releasing an egg. However, pain that occurs immediately after your period ends—during the gap between menstruation and ovulation—falls into a different category and often warrants a closer look.

Here are the most common culprits for lower abdominal pain after menstruation.

1. Endometriosis: The Hidden Inflammation

Endometriosis is a chronic condition where tissue similar to the lining of the womb starts to grow elsewhere in the body—usually on the ovaries, fallopian tubes, and pelvic lining.

While endometriosis is famous for causing agonising period pain, the suffering doesn’t always stop when the bleeding does. This rogue tissue bleeds just like your womb lining does during your period, but unlike menstrual blood, it has no way to leave the body. This leads to inflammation, swelling, and the formation of scar tissue (adhesions).

Why it causes pain after your period:
Even after menstruation ceases, the internal inflammation can persist. The scar tissue can cause organs to stick together, leading to a dragging sensation or sharp pains in the pelvis that can last for days or weeks. Other tell-tale signs include pain during intercourse, pain during bowel movements, and chronic fatigue.

2. Ovarian Cysts: Fluid-Filled Troublemakers

The ovaries are busy organs, and sometimes fluid-filled sacs called cysts develop on them. Many women have functional cysts that form as part of the normal menstrual cycle and disappear on their own without ever causing symptoms.

However, sometimes cysts don’t disappear. They can grow large, causing a sense of heaviness or dull aches in the lower abdomen.

Why it causes pain after your period:
While cysts can cause pain at any time, large cysts may cause persistent discomfort that lingers after your cycle. If a cyst ruptures or causes the ovary to twist (ovarian torsion), the pain can be sudden and severe. If you experience sharp, sudden pain accompanied by nausea or vomiting, this is a medical emergency.

3. Pelvic Inflammatory Disease (PID)

Pelvic Inflammatory Disease is an infection of the reproductive organs, often affecting the uterus, fallopian tubes, and ovaries. It is frequently caused by sexually transmitted infections (STIs) like chlamydia or gonorrhoea that have been left untreated, though non-sexually transmitted bacteria can also be the cause.

Why it causes pain after your period:
Bacteria can travel up from the vagina into the uterus more easily during menstruation when the cervix is slightly open. This can lead to an infection taking hold or worsening right after your period ends. Unlike cramps, PID pain is often described as a constant ache in the lower belly.

Look out for additional symptoms such as:

• An unusual or foul-smelling vaginal discharge.
• Pain or bleeding during sex.
• Fever or chills.
• Pain when urinating.

PID requires urgent antibiotic treatment to prevent long-term damage to your fertility.

4. Uterine Fibroids

Fibroids are non-cancerous growths that develop in or around the uterus. They are incredibly common, and while many women don’t know they have them, they can cause significant issues for others.

Why it causes pain after your period:
Fibroids can create a feeling of pelvic pressure or heaviness that doesn’t obey the calendar. Large fibroids can press against other organs or the pelvic wall, causing a constant dull ache. Furthermore, if a fibroid begins to degenerate (break down because it has outgrown its blood supply), it can cause acute pain that persists well beyond your period.

5. Gastrointestinal Issues

Because the reproductive organs sit so snugly next to the bowel and bladder, it is easy to confuse “womb pain” with “gut pain.”

Conditions like Irritable Bowel Syndrome (IBS) often flare up during or after menstruation due to hormonal fluctuations. Prostaglandins—the chemicals that make your uterus contract—can also make your bowels contract. If your post-period pain is accompanied by bloating, diarrhoea, or constipation, the root cause might be gastrointestinal rather than gynaecological.

When Should You Seek Help?

It is easy to minimise pain. Women are often conditioned to believe that pelvic pain is their burden to bear. However, pain is a symptom, not a lifestyle.

You should seek medical advice if:

• The pain is new: If you have never experienced this before, get it checked.
• It disrupts your life: If you are missing work, cancelling social plans, or relying on painkillers just to get through the day.
• You have “Red Flag” symptoms: Fever, vomiting, fainting, or severe pain that stops you in your tracks requires immediate attention.

The Importance of Diagnosis

Diagnosing pelvic pain can be like solving a puzzle. Because the symptoms of endometriosis, cysts, and PID often overlap, a professional assessment is vital.

This will typically involve a physical examination and likely an ultrasound scan to look at the uterus and ovaries. Your doctor may also take swabs to rule out infection.

If you feel your concerns are being dismissed, or if standard GP appointments aren’t providing answers, consider seeing a specialist. Booking a consultation with a private gynae can often provide the dedicated time and specialised diagnostic tools needed to get to the root of complex pelvic conditions.

Conclusion

Lower abdominal pain after menstruation is common, but that does not make it normal. It can be a sign of underlying conditions like endometriosis, ovarian cysts, or infection that require treatment.

Your body is resilient, but it shouldn’t have to be in pain constantly. By understanding the potential causes and recognising when to seek help, you take control of your reproductive health. Do not suffer in silence hoping it will go away next month—listen to your body and seek the care you deserve.